License Defense / The Disciplinary Process

Although the process varies from agency to agency, the following is a general summary which is followed by most licensing Boards and Agencies. For a more specific understanding please go to the useful links section and click on your respective Board’s rules.

The disciplinary process usually begins with either a letter of self-report or a complaint from a patient, employer, co-worker, or angry spouse. Impairment due to drugs and alcohol, the filing of criminal charges or a criminal conviction can also trigger and investigation into nurse misconduct and alleged violations of a health care practice act such as the Nursing Practice Act or the Dental Practice Act.

Once the investigation is complete the material and evidence gathered is sent to the legal department and reviewed. If it is determined that probable cause exists to believe the licensee committed ethical misconduct and violated their respective “Practice Act” formal charges may be filed and the licensee then has the opportunity to schedule an Informal Settlement Conference (ISC) to resolve the matter informally. In cases where the alleged misconduct is severe or it is apparent that the licensee poses a continuing threat to the health, safety and welfare of the public the Board may immediately file formal charges through the State Office of Administrative Hearings (SOAH).

During the ISC the Board’s staff attorney begins with an opening statement and then presents its evidence and theory of the case to the Board’s panel members. The licensee (Respondent) is then given a chance to present his/her defense and/or mitigation evidence in reply. They are then questioned by the panel members at length and each side is afforded the opportunity to present a closing argument. After a private review and consideration of the evidence the panel members decide if professional or ethical misconduct has been committed and they make recommendations for a sanction. The licensee is then informed of the panel’s decision and a formal offer is presented in writing –generally within one month of the hearing. The licensee is then afforded twenty days to accept or reject the offer. If the offer is rejected the Board will generally file formal charges against through SOAH.

The State Office of Administrative Hearings (SOAH) is the where hotly contested cases and matters of law are often decided. The proceeding is in front of an Administrative Law Judge and is similar in form to a civil trial. This is a complicated legal proceeding in which a health care professional will find themselves lost without the assistance of an attorney. Witnesses are called, evidence is submitted and at the conclusion the Administrative Law Judge renders a decision which includes findings of fact and conclusions of Law. The matter is then remanded to the Board for a disciplinary penalty or licensure action consistent with the SOAH Judge’s findings.

In the event either the Board or the licensee disagrees with the findings, or the Board does not issue a disciplinary sanction consistent with the Judge’s opinion, then the matter can be appealed to District Court and beyond if necessary. Please see the section on appeals for a further explanation of the Appellate Process.